Psychiatric Illness More Prevalent in People With Ulcerative Colitis

OCTOBER 29, 2019

Alexandra Ward

Patients with inflammatory bowel disease, such as ulcerative colitis (UC), are at an increased risk of developing mental illness, but the body of evidence to date has been limited by studies with small sample sizes.

In research presented at the American College of Gastroenterology’s Annual Scientific Meeting (ACG 2019) in San Antonio, Texas, investigators with University Hospitals Cleveland Medical Center and Cleveland Clinic Foundation relied on data collected via a large sample population to examine the epidemiology of psychiatric illness, such as major depressive disorder (MDD), anxiety disorder, and bipolar disorder, in people living with UC.

The study team combed through a commercial database containing electronic health record data from 26 major integrated US healthcare systems to aggregate a patient cohort of individuals with a diagnosis of UC and depression, anxiety, and bipolar disorder between 2014 and 2019 using the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT).

Patients without UC but with a diagnosis of depression, anxiety, and bipolar disorder were also included, and investigators calculated overall prevalence of psychiatric illness in UC among various groups, using univariate analyses to identify risk factors for psychiatric illness among patients with UC.

Prevalence of psychiatric illness (depression, anxiety, and bipolar disorder) among patients with UC was 17% (22,780), 23% (28,480), and 4% (5,140), respectively, and psychiatric illness was more prevalent in patients with UC than those without the disease.

Among patients with UC, elderly individuals (age >65 years old), females, and Caucasians were more likely to be affected by psychiatric illness. Patients with psychiatric illness and UC were more likely to have a history of alcohol abuse, tobacco use, substance use, personality disorder, and corticosteroid use compared with patients with psychiatric illness but without UC.

“This is one of the largest studies to date to describe the epidemiology of psychiatric illness in UC. Individuals with UC were more likely to suffer from depression, anxiety, and bipolar disorder compared to their non-UC counterparts,” investigators concluded. “Psychiatric illness is under recognized in UC and should be screened for and treated accordingly.”